Myofascial pain is chronic pain that arises from the muscle sheath called fascia and is caused by prolonged muscle overload, for example, due to prolonged computer work with no elbow support, driving with hands on the top of the steering wheel, walking a strong pulling dog or carrying heavy objects.

Infraspinatus strain or tear can occur during sports that include reaching back with a hand, such as tennis or baseball, or even when pulling off the shirt or throwing something into the back of your car.

Infraspinatus atrophy (muscle wasting) can result from a muscle tear or damage (neuropathy) of the suprascapular nerve, mainly in athletes with frequent overhead activities (baseball, volleyball, tennis) [5].

Symptoms and signs:

Deep pain in the front of the shoulder joint and, sometimes, down the outer side of an arm

Difficulty pushing objects or opening the door

Difficulty reaching backward

Difficulty sleeping on the affected side

Applying pressure on the trigger points can cause pain that radiates down the outer side of the arm toward the thumb and index finger.

With time, untreated tear can result in muscle wasting (atrophy) with a visible depression below the spine of the scapula [4]

Picture 2. Infraspinatus muscle trigger points
(2 red dots over the scapula in the left image)
and pain distribution

Infraspinatus Pain Test

Test 1: Painful arc test. While standing, raise an extended arm on the affected side sideways all the way up. If you feel pain in the shoulder or upper arm when your arm is raised between 70 and 110 degrees but not before or after that, it means your infraspinatus tendon is probably affected.

Treatment

Treatment of infraspinatus myofascial pain includes massage with a tennis or lacrosse ball against a wall or myofascial release — a massage of trigger points performed by a physiotherapist.

Treatment of infraspinatus tear can include [3]:

Rest from the activities that cause pain (2-3 months or longer)

Friction massage for 4-6 weeks, which prevents adhesions

Exercise therapy every day for 6-8 weeks

Exercise

In a strained/ruptured infraspinatus, exercises should be performed only to the point of pain.

Shoulder adduction[3]. While standing, raise your arm on the affected side forward, so your elbow will be at the level of the shoulder and your forearm will point upwards. Grab the elbow with the other hand and pull it toward the opposite shoulder. Sustain for 30 seconds, release and repeat 5 times.